HomeMy WebLinkAbout15072-zFORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.., .z7.1.6.8..2 ? ....... Date ...A.l?.r.i.1...2.8.,.. ! .9.8.8 .............
THIS CERTIFIES that the building DE CK ADDITION
toaaflnnofPronmrtv 1720 Leeward Drive Southold, New York
............ ~--"House .............................. No. 'S'd~i ................... ' ........ t~m~ot
County Tax Map No. 1000 Section 079 .Block 07 .Lot 43.2
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
May 17, 1986 15072Z
..................... pursuant to which Building Permit No ............... '
dated .... J.. u..1 y..9.:..1.9.8............6 . was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
DECK ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to STANLEY & MARGARET BROWN
..................... ?o¥.'e;, ~y4~ ~¥f~Jr .....................
of the aforesaid building.
N/A
Suffolk County Department of Health Approval ..........................................
~q/A
UNDERWRITERS CERTIFICATE NO ................................................
N/A
PLUMBERS CERTIFICATION DATED:
Rev. 1/81
TOWN OF $OUTHOLD
BUILDIHG DEPARTMENT
TOWH HALL
SOUTHOLD, N. Y.
BUILDiHG PERMIT
(THIS pERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°. 15O72
Z
Permission is hereby granted to:
...~..a.~.~....~..~ .......................
.~,.....~.:..~.:....L.c~.~../ .......
o ,rem, e ,Led ........ ................
County Tax Map No. 1000 Section ..... ..~....']...~ ....... Block ....... ..~.~. ....... Lot No.....LLc..~.~.~.. ....
~ur~ua~t to o,p,,co,,o, do,~ .... ~..~..L-J. .................... , ,9.~.~, omd app,ov~ b~ ,Ne
Building Inspector.
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Bu tiding Department
Town Hall
Southold, N.Y. 11971
765- 1802
PLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic featu res.
2. Final approval of Health Dept. of water supply and sewerage disposal-(S-g form or equat).
3. ~;pproval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or
topographic featu res.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy New Dwelling,S25.00, Accessory,;$t0.00 Business $50.00
2. Certificate oCoccupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date ..O,/~...~./(~.T/ .............
NewCons bruc ~;ion ...... Old or Pre-existing Building / Vacant Land
Location of Property .~. ~V ~,
Owner or Owners of Property .......... ~. ..... ~.'/7g. ................
County Tax Map No. 1000 Section ....-7.q ........ Block ..... .~ ......... Lot...4 .~.'..2~. ......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No..~.O.-/~..--~.. Date of Permit~/(.~/.~.~...Applicant..J .... T~. 'r'cw~ ..... T~Tku. ~ .......
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ X~., 0.~,
Construction on above described buildin~r~/~ermit meets all app!icable codes and regulations.
Applicant .~.~. ~ .................
Rev. 10-10-78
TOWN OF £OUTIIOLD
OFf'ICI,; OF BUILDING INSPECTOR
P.O. BOX 728
TOWN IIALL
SOUTIIOLD, N.Y. 11971
October 22, 1987
TEL. 765-1802
Mr. & Mrs. Stanley Brown
1720 Leeward Drive
Southold, New York 11971
To Whom 'J'hif; May Concern~
Re: Building Permit #14583 ~ ~ Addition
Building Permit #15072 Deck
Wo are unable to complete your Certificate
Occupancy becaut;e .of tile following reasons.
An application for Certificate of Occupancy
iy; not on file.
No (J__n~]{,~rwriters Certificate on file. B.P. #]4583 Z
J.!; (~.Uti,lat?~d~/n~m~x~x~i~o~) Returned herewith. Please
Submit new check - $50.00
lle~lth Dept. Approval. on file.
final in~;pecLi(~n has been made,
Pica.q(3 contact our office on %his matter.
Thank yo~t for your cooperatioil.
l!u[l(linc.~ Permit ~ Z
~**/][/ No Plumb~:r ~;older Certificate on file.
( all permits invplving plumbing being
issued after April 1,1984 )
~ (}~'('tlI>,~ncy or uso is U~llaWf'tll w~thotlt a Certificate
FIELD I~SFECTION
1.
FOUNDATION (1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
COM~ENTS
ADDITIONAL COMMENTS:
7GS-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
INSPECTOR
· FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined...~t~..~ ..... , 19 ?.~.
Approved...7/.,~.~',,,U ...... 19~.~.. Permit No/..~.~.7..a_..~..
Disapproved a/c .....................................
................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
I4AY 2 2 1986
'~" TOWN OF '~OU~tiIOLD
Received ........... ,19...
INSTRUCTIONS
a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or are.as, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit·
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throu~hout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit autliorized inspectors on premises and in building for nece~ssary inspections. ~
(Signa°ture of applicant, or name, if a corporati )
· .l~p., ..k~.~..?~: .s.~h ;~.~.....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
· .~. .......... 9..~. ~.c-~ .....................................................................
Name of owner of premises.....~q~P~-;T-. ....... ... .~.~..x~.'.,~. ...........................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No....4~...~ .................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
v7.2. ~. ~.~...~¢. ~ . .~..~.v..~. ........ .<o~~. · ~ ~:.~'.- ...................................
House Number Street Hamlet
County Tax Map No. 1000 Section .... .--~.c]. ........... Block ..... .'7 ........... Lot...~-..~.. :'.~. ..........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... .~.l.~. ~-~....~. ~.. ) .~.~....~.'~...r~..~ ...............................
b. Intended use and occupancy ..................................................................
o
~9.
.¥10.
11.
12.
13.
14.
Nature of work (check which applicable): New Building ..... ' .....Addition .. ! ....... Alteration .....
Repair .............. Removal .............. Demolition ........... !... Other Work..-.~.~.
~ (Description)
Estimated Cost Fee
'a (to be paid on filing this application)
If dwelling, number of dwelling units .............. Number of dwelling unitls on each floor ................
If garage, hum her of cars ............................................ ,i ............................
If business, commercial or mixed occupancy, specify nature and extent of each type of use .......... .....
Dimensions of existing structures, if any' Front. (.~ - O Rear ! ?_- o I'~ - o
................... ....... Depth ...............
Height ............... Number of Stories ...~-/qlfTO.'~..tv-....~....~-~... ~.¢-~-... ~. ?,~qx..~..~..~,~.~ .......
Dimensions of same structure with alterations or additions: Front .... /..~.7.~... !'. .... Rear ...I..~.-..O. .......
Depth ..... I.q.~-: 9. ...........Height ...................... Number ofiStories .~.~.. ?D.~rr..~.
Dimensions of entire new construction: Front ... !~r.-.o. ....... Rear ... [~f.-.O. .......Depth ...I.o.-.(o....~2 ..
Height ............... Number of Stories . ~-~2.'I>.~... gr-).~?~..~ .~..c'7.. i ~:~...~.....h~ . .~. ~..c_~'.. ..'
Date of Purchase .~.u.~%l~['{.~ ................... Name of Former Owner
Zone or use district in which premises are situated ' '
Does proposed construction violate any zoning law, ordinance or re lation' .... ,.~ O ... '
Will lot be regraded .... .l~...O. ................... Will excess fill be removed from premises: Yes
Name 'of Owner of premises tfllW..~T..BCq~..~. .... Address ~."1.:~...~.'~. ,5~..~hone No. 7.~. ~..': I.t~.6."/ ....
Name of Architect ....... ' .................... Address ............... i .... Phone No ................
Name of ContractOr 4{ ~.~¢9.Ir'~q~. ~.'C...r.~.. Address ~r/~. t~.~ .~. :t~./~.~4 .~.Ophone No..-/./~. ~.Z/./q .~..~ ....
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot. :
STATE OF NEW YORK.
COUNTY OF...~.k)..~..¢~o. ?..~.. S.S
....... · ~..~?~..'~. · · .~..~..~??..~J. ................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract) ~.
above named.
He is the ........................................................... ~ ............................
(Contractor, agent, corporate officer, etc.}
of said owner or owners, and is duly authorized to perform or have performed the Said work and to make and file this
application; that all statements contained in this application are true to the best of hi! knowledge and belief; and that tho
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
i ........ X' 'r~' ' '~' ' ...... dayof .... ~ .~-.~ ............ 19..~.%
?Notary Public,... . ~.. ~...~.~.. ....... Coun. ty ,
.......
~1~_~7 (Signature of applicant)
Term'fipi~
RENSSELAER G. TERRY, ,~R
ATTORNEY AT LAW
52645 MAIN ROAD
5OUTHOLD, N. Y. 11971
(516) 765-2300
YOUNG & YOI
400 OSTRANDER AVENUE, RiVERI
SURVEY FOR:
STANLEY G. BROWN ~,MARGARET H.BROWN
PARTOF LOTS 50~51
"LE EWAR D ACRES AT BAY VIE W"
BAYVIEW
TOWN Or SOUTHOLD
SUFFOLK CO., N.Y.
SC^L~: t,, = 50" [~,,,'rF.: MAY 30, i97'5